Ultimate Guide to Body Contouring

1. THE ULTIMATE guide toBODY CONTOURING naiduplasticsurgery.com

2. ABOUTNINA S. Naidu, MD, FACS • naiduplasticsurgery.com • Integrity, honesty, and patient safety are the top priorities in the surgical practice of Nina S. Naidu, MD, FACS. Patients are treated with kindness and respect, whether they are undergoing a reconstructive or a cosmetic procedure. Dr. Naidu spends a great deal of time with her patients during their consultations. It is her goal for these visits to be as educational as possible, without pressure to schedule a procedure. • Aesthetic and reconstructive surgery of the breast and body comprise a large part of Dr. Naidu’s surgical practice. She has a special interest in combined breast and abdominal surgery for women who have finished having children, also known as the “mommy makeover”. Dr. Naidu has also selectively introduced non-invasive body contouring treatments, including CoolSculpting® and PelleFirm™, for patients who may not be surgical candidates.

3. SELECTING THE RIGHTplastic surgeon • naiduplasticsurgery.com Take your time thinking about which plastic surgeon you would like to perform your body contouring procedure. Look into the following information about your plastic surgeon before your consultation: • Plastic surgery specialty • Plastic surgery board-certification by the ABPS • Years of experience and training • Hospital privileges • Surgical facility and accreditation by a national or state agency Ask for referrals from friends and family, research plastic surgeons in your area, and contact the following professional organizations: • American Board of Plastic Surgery (ABPS) • The American Society of Plastic Surgeons (ASPS)

4. ASK THE RIGHTQUESTIONS • naiduplasticsurgery.com A consultation for a body contouring procedure includes a discussion of your desires as well as your concerns about the procedure. Approach your plastic surgeon with the following questions and evaluate his/her bedside manner: • Are you certified by the American Board of Plastic Surgery? • Were you specifically trained in the field of plastic surgery? • How many years of plastic surgery training have you had? • Do you have hospital privileges to perform this procedure? If so, at which hospitals? • Is the office-based surgical facility accredited by a nationally or state-recognized accrediting agency, or is it state-licensed or Medicare-certified? • Am I a good candidate for this procedure? • What will be expected of me to get the best results? • Where and how will you perform my procedure? • What surgical technique is recommended for me? • How long of a recovery period can I expect, and what kind of help will I need during my recovery? • What are the risks and complications associated? How are complications handled? • How can I expect my body to look over time?

5. AN INTRODUCTION TOBODY CONTOURING • naiduplasticsurgery.com • Time, pregnancy, heredity, age, and lifestyle all affect our bodies in various ways.  Some of us notice fat deposits in specific areas, while others have regions of sagging skin. An abdominoplasty, or tummy tuck, removes excess skin and fat to create a tight and flat abdomen. • Liposuction is an excellent modality which can target localized areas which have not responded to diet and exercise.  The hips, thighs, buttocks, abdomen, arms, and neck are all areas which can be recontoured.  It is often performed in conjunction with other procedures, including abdominoplasty, to further refine the surgical results. • The “mommy makeover” refers to plastic surgery after pregnancy, and usually targets both the breasts and the abdomen to reverse post-pregnancy changes.  These procedures may be combined or performed separately, and generally include one or more of the following: breast augmentation, breast lift, breast reduction, tummy tuck, and liposuction.

6. THE PROCEDURELIPOSUCTION • naiduplasticsurgery.com Liposuction is a procedure that can sculpt the body by reducing the size of areas with excess fat, including the hips, thighs, buttocks, knees, abdomen, upper arms, breast, and submentum (under the chin). It can address areas that do not respond well to weight loss or exercise, but it is not a replacement for these treatments. The best candidates for liposuction are patients with good skin tone who have pockets of excess fat in localized regions. Fat cells which have been removed do not return, but the remaining fat cells will expand if the patient gains weight after surgery. Liposuction may be performed on several areas of the body at the same time, and it can also be combined with other procedures. Liposuction takes between 1 and 3 hours to perform depending upon the number and size of the areas that are being treated. The surgery is performed on an ambulatory basis in the office or at an outpatient surgery center. Local anesthesia alone may be sufficient for small areas, but for larger areas general anesthesia is recommended.

7. THE RISKS & COMPLICATIONSLIPOSUCTION • naiduplasticsurgery.com All surgery carries risks. The most frequently reported complications after liposuction are as follows: • Bleeding: Bleeding from your incisions is unusual but can occur following surgery. In most cases gentle pressure is sufficient to stop any oozing. • Infection: Infection following liposuction is very unusual. You will be given an antibiotic prior to surgery. • Pain: Most patients report only mild discomfort following surgery. • Numbness: Many patients have numbness at the sites of their liposuction for weeks to months following surgery. • Scarring: You will have small scars following surgery. Although the scars improve with time, they may remain apparent. • Necrosis: Necrosis, or the death of skin and fat, may occur in smokers, following an infection, or with the use of steroids. This complication may require additional surgery. • Bloodclots: Blood clots may form in the legs, or travel to the lungs. This is a potentially fatal complication, and therefore preventive measures, including the use of leg compression devices during surgery, are taken with every patient. • Swelling: A small number of patients may experience prolonged swelling after surgery. • Contourdeformitiesandirregularities: In some cases, indentations at the site of the liposuctioned areas may be visible. • Anesthesiarisks: Although general anesthesia and sedation are very safe, all patients are screened for any personal or family history of anesthesia reactions.

8. THE RECOVERYLIPOSUCTION • naiduplasticsurgery.com • Following liposuction, you will awaken in the recovery area. Once you are fully alert, you will be transported to a step-down area where you will be given something to eat prior to discharge. You will have a surgical garment placed at the conclusion of the procedure. A responsible adult will need to be available to escort you home. • Patients are seen in the office 3-5 days following surgery for sutures removal and a brief examination. • Walking is permitted the day of surgery, but strenuous activity is limited for 2 weeks following surgery. Most patients do not complain of severe pain following surgery, but note soreness and numbness of the skin. Pain medication is prescribed for any discomfort. Swelling will be present for the initial 2-3 months after surgery, and the final results are typically seen 3-6 months after surgery. The scars will continue to fade and soften for up to one year following surgery.

9. THE PROCEDURETUMMY TUCK • naiduplasticsurgery.com • After pregnancy or weight loss, excess skin and fat can distort the appearance of the abdomen. In particular, many women find that after their second child or after bearing twins, their muscles and skin do not return to their original appearance secondary to repeated stretch of the abdomen. The abdominoplasty, or “tummy tuck” procedure, creates a flatter, firmer abdomen by removing excess fat and skin, and tightening the abdominal muscles. • The procedure averages two hours in length, and is performed in the hospital or in an ambulatory center under general anesthesia. Most patients are able to return home that evening.

10. THE RISKS & COMPLICATIONSTUMMY TUCK • naiduplasticsurgery.com All surgery carries risks. The most frequently reported complications after tummy tuck surgery are as follows: • Hematoma: A collection of blood underneath the skin can occur. Should this happen, you will most likely note a sudden increase in your drain output. Bleeding requires an immediate return to the operating room to stop the bleeding vessel and evacuate any blood. • Seroma: A seroma is a collection of clear fluid underneath the skin. This is removed by drains after surgery. After your drains have been removed, any persistent fluid collection can be removed in the office by using a small needle. Strict adherence to the garment-wearing schedule will reduce your chance of seroma formation. Seromas can result in an infection or an unsatisfactory cosmetic result if left untreated. • Infection: Infection following abdominoplasty surgery is rare. You will be given an antibiotic prior to surgery, and a prescription for an antibiotic for 5 days after surgery. • Scarring: You will have a permanent scar following abdominoplasty surgery. Although the scar improves with time, it will not completely fade. • Necrosis: Necrosis, or the death of skin and fat, may occur in smokers, following an infection, or with the use of steroids. • Pain: Most patients report mild to moderate discomfort following surgery. • Blood clots: Blood clots may form in the legs, or travel to the lungs, following surgery. This is a potentially fatal complication, and therefore preventive measures are taken with every patient. • Numbness: Most patients will note numbness over the abdominal wall for several months. • Anesthesiarisks: Although general anesthesia is safe, patients are screened for any personal or family history of anesthesia reactions.

11. THE RECOVERYTUMMY TUCK • naiduplasticsurgery.com • Following your tummy tuck surgery, you will awaken in the recovery area. Once you are fully alert, you will be transported to a step-down area where you will be given something to eat prior to discharge. You will have two drains and a surgical garment placed at the conclusion of the procedure. The nurses in the recovery area will demonstrate how to empty and record the output from your drains. A responsible adult will need to be available to escort you home. • Patients are seen in the office one week following surgery. At that time your drains will be removed and you will be placed into a compression garment. Most sutures placed will dissolve on their own. • Walking is permitted the day after surgery, but strenuous activity and heavy lifting are limited until six weeks following surgery. Most patients do not complain of severe pain following this surgery, but note that the abdomen feels “tight”, as if they have performed many sit-ups. Pain medication is prescribed for any discomfort. Swelling will be present for the initial 2-3 months after surgery, and the final results are typically seen 3-6 months after surgery. The scar will continue to fade and soften for up to one year following surgery, although it will never completely disappear.

12. THE PROCEDUREPELLEFIRM™ • naiduplasticsurgery.com • The PelleFirm™ device was recently FDA-approved as a non-invasive, radiofrequency-based treatment for the temporary improvement of the appearance of cellulite. • The system used a large diameter handpiece to elevate tissue temperature up to 45 degrees Celsius, coupled with mechanical massage heads for treatment of areas with cellulite. PelleFirm™ can address almost any area of the body and is ideal for problem zones such as the abdomen, arms, buttocks and thighs. It an be used on all skin types, and is a comfortable treatment. There is no downtime following the procedure. Most patients will require 3-4 treatments to see results.

13. THE PROCEDURECoolsculpting® • naiduplasticsurgery.com • CoolSculpting® works on the principle of cryolipolysis, in which targeted tissue is precisely cooled.  The fat cells beneath the skin are crystallized and then die, while the skin, blood vessels, and nerves are not affected.  Over time, the body processes the fat and eliminates the dead cells.  The result is targeted sculpting of the body. • The CoolSculpting® procedure is approved by the Food and Drug Administration (FDA) for treatment of the abdomen, flanks, inner thighs, outer thighs, and under the chin. Ideal candidates can achieve a reduction of approximately 20% of fat in the areas treated.  The procedure is non-surgical, and requires no incision or needles.  Anesthesia is not required, as there is only a sensation of mild tugging during the procedure.  Patients may return to normal activities immediately.

14. view Our photo gallerybefore & After • naiduplasticsurgery.com View before and after images of our patients who have had body contouring procedures to see examples of our results and to help visualize what your own results may be like. Search through our before and after photo gallery for more images to help you visualize your desired results. CoolSculpting® Tummy Tuck

15. LOOKING INTO OTHERresources • naiduplasticsurgery.com To help get you started on your journey through research, surgery, and recovery, view the helpful resources below. These resources can help connect you to those in the community who have had plastic surgery, information on plastic surgery, and common questions answered about plastic surgery: • American Society for Aesthetic Plastic Surgery • American Society of Plastic Surgeons • RealSelf • Smart Beauty Guide